Heights University Hospital

All Charges

Charge

Type

Setting

Price

FP CHEM CAUT GRAN TISSUE

Facility

$1,083.25

Service Code	HCPCS 17250
Hospital Charge Code	87502525
Hospital Revenue Code	761
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$541.62
Rate for Payer: Aetna Commercial	$324.98
Rate for Payer: Aetna Medicare Advantage	$324.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$276.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$276.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$276.23
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.82
Rate for Payer: Oxford Commercial	$541.62
Rate for Payer: Qualcare PPO/HMO/WC	$162.49
Rate for Payer: UnitedHealthcare Commercial	$541.62

FP CHEM CAUT GRAN TISSUE

Facility

$1,083.25

Service Code	HCPCS 17250
Hospital Charge Code	87502525
Hospital Revenue Code	761
Min. Negotiated Rate	$162.49
Max. Negotiated Rate	$162.49
Rate for Payer: Qualcare PPO/HMO/WC	$162.49

FP COLLECTION CAP BLOOD SPECIM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	87502775
Hospital Revenue Code	300
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

FP COLLECTION CAP BLOOD SPECIM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	83652103
Hospital Revenue Code	300
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

FP COLLECTION CAP BLOOD SPECIM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	87502775
Hospital Revenue Code	300
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

FP COLLECTION CAP BLOOD SPECIM

Facility

$58.00

Service Code	HCPCS 36416
Hospital Charge Code	83652103
Hospital Revenue Code	300
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$17.40
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$23.46

Service Code	HCPCS 17003
Hospital Charge Code	83652083
Hospital Revenue Code	510
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$7.04
Rate for Payer: Aetna Commercial	$7.04
Rate for Payer: Aetna Medicare Advantage	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.98
Rate for Payer: Cigna Commercial	$1.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.05
Rate for Payer: Qualcare PPO/HMO/WC	$3.52

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$23.46

Service Code	HCPCS 17003
Hospital Charge Code	87502650
Hospital Revenue Code	761
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$3.52
Rate for Payer: Qualcare PPO/HMO/WC	$3.52

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$23.46

Service Code	HCPCS 17003
Hospital Charge Code	83652083
Hospital Revenue Code	510
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$3.52
Rate for Payer: Qualcare PPO/HMO/WC	$3.52

FP CRYO PREMLG 2ND-14 LESIONS

Facility

$23.46

Service Code	HCPCS 17003
Hospital Charge Code	87502650
Hospital Revenue Code	761
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$11.73
Rate for Payer: Aetna Commercial	$7.04
Rate for Payer: Aetna Medicare Advantage	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.98
Rate for Payer: Cigna Commercial	$1.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.05
Rate for Payer: Oxford Commercial	$11.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.52
Rate for Payer: UnitedHealthcare Commercial	$11.73

FP CRYO PREMLG LES 1ST LESION

Facility

$268.40

Service Code	HCPCS 17000
Hospital Charge Code	87502645
Hospital Revenue Code	761
Min. Negotiated Rate	$34.89
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$80.52
Rate for Payer: Aetna Medicare Advantage	$80.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.44
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.89
Rate for Payer: Oxford Commercial	$134.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.26
Rate for Payer: UnitedHealthcare Commercial	$134.20

FP CRYO PREMLG LES 1ST LESION

Facility

$268.40

Service Code	HCPCS 17000
Hospital Charge Code	87502645
Hospital Revenue Code	761
Min. Negotiated Rate	$40.26
Max. Negotiated Rate	$40.26
Rate for Payer: Qualcare PPO/HMO/WC	$40.26

FP CRYO PREMLG LESION; 1ST LES

Facility

$268.40

Service Code	HCPCS 17000
Hospital Charge Code	83652081
Hospital Revenue Code	510
Min. Negotiated Rate	$34.89
Max. Negotiated Rate	$477.79
Rate for Payer: Aetna Commercial	$80.52
Rate for Payer: Aetna Medicare Advantage	$80.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.44
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.89
Rate for Payer: Qualcare PPO/HMO/WC	$40.26

FP CRYO PREMLG LESION; 1ST LES

Facility

$268.40

Service Code	HCPCS 17000
Hospital Charge Code	83652081
Hospital Revenue Code	510
Min. Negotiated Rate	$40.26
Max. Negotiated Rate	$40.26
Rate for Payer: Qualcare PPO/HMO/WC	$40.26

FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	87502445
Hospital Revenue Code	761
Min. Negotiated Rate	$44.55
Max. Negotiated Rate	$44.55
Rate for Payer: Qualcare PPO/HMO/WC	$44.55

FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	87502445
Hospital Revenue Code	761
Min. Negotiated Rate	$32.18
Max. Negotiated Rate	$1,639.38
Rate for Payer: Aetna Better Health Medicaid	$1,607.24
Rate for Payer: Aetna Commercial	$89.10
Rate for Payer: Aetna Medicare Advantage	$89.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.73
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.61
Rate for Payer: Oxford Commercial	$148.50
Rate for Payer: Qualcare PPO/HMO/WC	$44.55
Rate for Payer: UnitedHealthcare Commercial	$148.50
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38

FP DEBRID SKIN & ADDITN'L 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	83652015
Hospital Revenue Code	761
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$13.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$186.00

FP DEBRID SKIN & ADDITN'L 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	83652015
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

FP DEBRID SKIN & ADDTL 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	87502450
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

FP DEBRID SKIN & ADDTL 10%

Facility

$372.00

Service Code	HCPCS 11001
Hospital Charge Code	87502450
Hospital Revenue Code	761
Min. Negotiated Rate	$13.16
Max. Negotiated Rate	$186.00
Rate for Payer: Aetna Commercial	$111.60
Rate for Payer: Aetna Medicare Advantage	$111.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.86
Rate for Payer: Cigna Commercial	$13.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.36
Rate for Payer: Oxford Commercial	$186.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$186.00

FP DEBRID SKIN & SUBC TISSUE

Facility

$356.32

Service Code	HCPCS 11042
Hospital Charge Code	83652017
Hospital Revenue Code	761
Min. Negotiated Rate	$44.88
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$106.90
Rate for Payer: Aetna Medicare Advantage	$106.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.86
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.32
Rate for Payer: Oxford Commercial	$178.16
Rate for Payer: Qualcare PPO/HMO/WC	$53.45
Rate for Payer: UnitedHealthcare Commercial	$178.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

FP DEBRID SKIN & SUBC TISSUE

Facility

$356.32

Service Code	HCPCS 11042
Hospital Charge Code	83652017
Hospital Revenue Code	761
Min. Negotiated Rate	$53.45
Max. Negotiated Rate	$53.45
Rate for Payer: Qualcare PPO/HMO/WC	$53.45

FP DEBRID SKIN & SUB CU TISSUE

Facility

$356.32

Service Code	HCPCS 11042
Hospital Charge Code	87502455
Hospital Revenue Code	761
Min. Negotiated Rate	$44.88
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Better Health Medicaid	$1,037.98
Rate for Payer: Aetna Commercial	$106.90
Rate for Payer: Aetna Medicare Advantage	$106.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$90.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$90.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$90.86
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.32
Rate for Payer: Oxford Commercial	$178.16
Rate for Payer: Qualcare PPO/HMO/WC	$53.45
Rate for Payer: UnitedHealthcare Commercial	$178.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74

FP DEBRID SKIN & SUB CU TISSUE

Facility

$356.32

Service Code	HCPCS 11042
Hospital Charge Code	87502455
Hospital Revenue Code	761
Min. Negotiated Rate	$53.45
Max. Negotiated Rate	$53.45
Rate for Payer: Qualcare PPO/HMO/WC	$53.45

FP DEST.CRYOTHERAPY LESIONS-14

Facility

$372.00

Service Code	HCPCS 17110
Hospital Charge Code	83652085
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

Know your out-of-pocket cost for care.

All Charges